We have previously demonstrated that low-dose IV ethanol predisposes elderly, sulfonylurea-treated patients with type 2 diabetes (T2DM) to reduced blood glucose concentrations during a fast. We hypothesized that orally administered ethanol prior to sleep would similarly predispose elderly, insulin-requiring T2DM subjects to reduced blood glucose concentrations overnight compared to placebo. Six subjects with T2DM (age = 56 ± 4 y, duration = 12 ± 7 y, HbA1C = 7.8 ± 1.7%, BMI = 28.1 ± 5.4 kg/m2) and nine nondiabetic subjects (age = 63 ± 6 y, HbA1C = 5.0 ± 0.2%, BMI = 26.5 ± 4.2 kg/m2) were admitted to the GCRC for two separate 24-hour studies. Glycemia was stabilized with a continuous infusion of IV insulin from 0900 to 2200. At 2200, subjects ingested doses of either 95% ethanol in sugar-free punch or sugar-free punch alone (placebo) to achieve blood alcohol concentrations of 0.10% (mild intoxication) by midnight during the ethanol arm of the study. During sleep, glucose, insulin and hormone concentrations were obtained at baseline and every 30 to 60 minutes between midnight and 0800. Results are shown below.
Similar to the sulfonylurea-treated T2DM subjects in our previous study, these data demonstrate that low doses of oral ethanol produce a small but significant decrement in overnight blood glucose in nondiabetic subjects. In contrast, low-dose oral ethanol does not affect overnight glucose in insulin-treated T2DM subjects. These results indicate that relative insulin deficiency may obscure the effects of oral ethanol on overnight glucose regulation in insulin-requiring T2DM patients overnight.
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